Endoscopy-assisted versus open tissue expander placement in plastic and reconstructive surgery: a meta-analysis

Area of Science:

• Plastic and Reconstructive Surgery
• Minimally Invasive Surgical Techniques
• Medical Device Technology

Background:

• Tissue expansion is crucial for reconstructive surgery but often involves lengthy processes and complications.
• Traditional open tissue expander placement carries risks such as infection, hematoma, and wound dehiscence.
• Optimizing expander placement techniques is essential to improve patient outcomes and reduce treatment duration.

Approach:

• A systematic review and meta-analysis adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
• Inclusion of seven studies comparing endoscopy-assisted and open tissue expander placement.
• Statistical analysis of complication rates, surgery time, hospital stay, and time to full expansion.

Key Points:

• Endoscopy-assisted placement showed a significantly lower overall complication rate (RD -0.28, p < .001).
• Reduced incidence of hematoma, infection, and dehiscence observed in the endoscopy-assisted group.
• Shorter surgery duration (WMD -13.97 min), hospital stay (WMD -16.88 h), and time to full expansion (WMD -27.54 days) were noted.

Conclusions:

• Endoscopy-assisted tissue expander placement offers a safer and more efficient alternative to open procedures.
• This technique is particularly beneficial for reducing complications in head and neck reconstructions.
• The findings support the adoption of endoscopy-assisted methods to improve patient recovery and surgical efficiency.